印度拉图尔糖尿病卫生保健设施的可得性、可及性和可负担性

B. Bansode, Rajeshwari A. Biradar, J. Prasad
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摘要

尽管负担巨大,但社区的糖尿病护理仍然不达标。根据在拉图尔区进行的研究,推荐的糖尿病护理与实际的糖尿病护理之间存在显著差距,这导致了不良的健康结果。在马哈拉施特拉邦的拉图尔区进行了横断面调查。2017年5月至10月,对来自413个家庭的505名自我报告的糖尿病患者进行了抽样调查。该研究使用了自我报告的糖尿病总样本进行双变量和多变量分析。只有19%的受访者表示,他们曾使用政府医院设施治疗糖尿病。老年人,属于在册种姓/在册种姓,从事农民/劳动力工作,以及贫困类别,可以获得政府的糖尿病治疗设施。大多数人无法进入医疗机构,因为超过三分之一的受访者居住在距离医院31公里以上的地方,原因是交通不便、缺乏连通性、医疗费用和进入医疗机构的时间非常难以负担。调整后的比值比显示,在控制了重要的背景因素后,发现了负担不起、距离遥远和前往医疗机构交通不便之间的联系。政府和私营部门必须紧急下放医疗设施,政府必须通过在分区中心、初级保健中心、农村医院以及地区和分区医院的特殊糖尿病部门提供健康检查来加强卫生系统。此外,私营部门和非政府组织必须采取措施,提高对糖尿病的认识,并在基层提供医疗服务。
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Availability, accessibility and affordability of diabetes health care facilities in Latur, India
Despite the enormous burden, diabetes care in the community is still substandard. According to studies conducted in the Latur District, there is a significant gap between recommended and actual diabetes care, which results in poor health outcomes. A cross-sectional survey was undertaken in the Latur District of Maharashtra. A sample of 505 self-reported persons with diabetes from 413 households were interviewed from May to October 2017. The study used total samples of self-reported diabetes for the bivariate and multivariate analyses. Only 19% of respondents reported that they accessed government hospital facilities for treatments of diabetes. Elderly, belonging to SC/ST, working as a farmer/labour, and poor categories accessed government facilities for diabetes treatment. Most of the people could not access healthcare facilities because more than a third of respondents live more than 31km from hospital facilities because of poor transportation, lack of connectivity, and highly unaffordable healthcare expenses and time access to healthcare facilities. The adjusted odds ratios show that after controlling for important background factors find the link between unaffordability, distance, and poor transportation to healthcare institutions. The government and private sector must urgently decentralize healthcare facilities, and the government must enhance the health system by making health check-ups available at sub-centres, PHCs, rural hospitals, and special diabetic departments in the district and sub-district hospitals. Furthermore, the private sector and non-governmental organizations (NGOs) have to take steps to raise diabetes awareness and provide healthcare services at the grassroots level.
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